Rights to Request Restrictions
You may request limitations on the use of your health information. For example, you can ask that your information not be shared with certain family members. We are not always able to comply with these requests. If we are unable to or do not agree to your request, we will let you know. If we do agree to a restriction, and the restricted information is needed for your emergency care, we may still use or disclose the information as we think appropriate.
Right to Request Alternate Methods of Communication
You may request an alternate method of receiving confidential mailings and other communications of your health information. For instance, you may request that your health information be sent to your office or to a post office box rather than to your home address. You may also request that calls be made to a certain telephone number. We do not require that you state a reason for your request.
Right to review and copy
You may request a copy of your health information. You may also request to review your health information. If your request is accepted, we will arrange a mutually agreeable time for you to look at your health information. We may deny your request to review and copy in a few limited circumstances. If your request is denied, you may ask for a review of that denial by contacting our privacy officer for the location where you received health services. This review will be done by our Program Director and we will comply with the decision of the reviewer. The contact numbers for our local privacy officers can be found under the section (below) that is titled “Privacy Officers and Patient Concerns”. Copies of health information may be provided to patients for a reasonable fee. We will let you know what the fee will be before a copy of your health information is made
right to receive a copy
Copies of this Privacy Notice will be available upon request at agency facilities and it is available on our website.
right to request an amendment
You may request an amendment to your health information if you think it is incorrect or incomplete. We may ask that the request is in writing and state the reasons for the amendment. We will notify you to let you know if we agree or disagree with your request. If we do not agree, we will provide you with information on why we disagree and what options you have. To request an amendment, please contact our local privacy officer at the location where you received care.
right to an accounting of disclosures
You have the right to request a periodic accounting of the disclosures of your health information so that you will be aware of who has had access to your information. Your request may specify a time period of up to six years. We are not required to provide an accounting for disclosures prior to April 14, 2003. Not every disclosure made is included in the accounting. Disclosures you authorized in writing, routine internal disclosures such as those made to agency personnel in the course of providing you services, and/or disclosures made in connection with payment are all examples of things not included in the accounting. The accounting will state the time of the disclosure, the purpose for which it was disclosed and a description of the information disclosed. If there is any fee for the accounting, we will let you know what it is before the accounting is done.
uses requiring patient authorization
There are some uses of health information that require patient Authorization. If your health information is requested for a use that requires your approval or Authorization, you will be told why your information is requested, who is asking for the information, and what information is requested. You will also be told how you may cancel (revoke) your Authorization. If we have already acted on an Authorization you gave us earlier, your cancellation will affect information release for the future.
privacy officers and patient
You may believe that your information has been handled in a way that respects your privacy. You may also seek to appeal a denial of your request to review or amend your health information. Please feel free to express your concerns to the privacy officer at the location where you receive treatment or where the information was handled improperly. Our privacy officers are very helpful and experienced in responding to questions about our treatment locations and services.
Please note that services we provide or pay for will not be affected by your raising a privacy issue. If you have a complaint or concern about your PHI, please call: